Federal prosecutors in the United States on Friday charged 11 individuals in a scheme orchestrated by a man from Russia to defraud Medicare—the American health insurance program—of $10.6 billion by fraudulently billing for expensive medical equipment. This is reported by UNN with reference to The Guardian.
Details
According to the indictment filed on June 18, a "transnational criminal organization" established a "multi-billion dollar healthcare fraud and money laundering scheme" which involved acquiring dozens of medical equipment companies from previous legitimate owners to perpetrate the fraud.
In a statement, prosecutors said that more than a million Medicare recipients had their personal information stolen, which the defendants used to submit billions of dollars in claims to Medicare and its supplemental insurers.
The claims were submitted through medical equipment providers acquired by the group, but no equipment was ever shipped.
Medicare paid out "approximately $41 million as a result of the fraudulent submissions," and supplemental insurers are estimated to have paid an additional $900 million between 2022 and 2024, prosecutors wrote.
The scheme was orchestrated by Imam Nakhmatullaev, who lives in Russia, officials said. He reportedly directed other defendants who were in Estonia, the Czech Republic, and the US.
The fraud was uncovered after hundreds of thousands of Americans reported their concerns to Medicare and its contractors after receiving explanations of benefits forms that indicated they had supposedly received equipment they did not order or receive, the indictment states.
According to the indictment, the organization transferred its proceeds through shell companies to bank accounts in countries like Singapore, Pakistan, and Israel, and laundered them using cryptocurrency, The New York Times reported.
Addition
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